Transcranial Magnetic Stimulation during Positron Emission Tomography: A New Method for Studying Connectivity of the Human Cerebral Cortex

Paus, Tomáš; Jech, Robert; Thompson, Christopher J.; Comeau, Roch M.; Peters, Terry M.; Evans, Alan C.

doi:10.1523/jneurosci.17-09-03178.1997

Cited by 651 publications

(371 citation statements)

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“…However, although TMS's penetration is limited to 2 cm, studies combining TMS with functional neuroimaging have revealed effects of TMS that are distant from the site of stimulation. 18,59,60 Furthermore, coils with a deeper power of penetration are being investigated for their potential clinical use. 61 In summary, although no recommendations on the use of this technique can be given, the promising results, non-invasiveness of TMS and good tolerability support further research with this technique.…”

Section: Discussionmentioning

confidence: 99%

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

et al. 2005

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Recent studies on the epidemiology of obsessive-compulsive disorder (OCD) estimate 50 million patients suffer from OCD worldwide, thus making it a global problem. The treatment of OCD has changed substantially over the last 2 decades following the introduction of selective serotonin reuptake inhibitors, which provide symptom improvement in ~60% of patients. However, some patients remain resistant to the standard pharmacologic and behavioral treatments. Although some Needs AssessmentIn the last decade, brain stimulation approaches to neuropsychiatric disorders have been increasingly investigated and are currently defining a "third way" of treatment besides the traditional ones, pharmacologic therapy and psychotherapy. Although some of these techniques are well-established treatments for specific conditions (ie, electroconvulsive therapy for severe depression or deep brain stimulation and transcranial magnetic stimulation in motor disorders) their efficacy in severe or treatment-resistant obsessive-compulsive disorder is still under investigation. Nevertheless, they represent a potential, helpful approach in this highly debilitating condition not only amongst the therapeutic approaches to obsessive-compulsive disorder but also as research means able to elucidate the specific dysfunctional neurocircuits underlying the clinical symptomatology. Learning ObjectivesAt the end of this activity, the participant should be able to:• Differentiate the specific techniques of brain stimulation investigated in the treatment of obsessive-compulsive disorder (OCD) in terms of efficacy, invasiveness, tolerability, and side effects.• Understand the main hypotheses through which these techniques might modify the dysfunctional circuits of OCD.• Understand the potential of these techniques in the field of treatment-resistant OCD, on one hand, and their current investigational state that requires further controlled clinical trials, on the other hand. Target Audience Neurologists and psychiatrists Accreditation StatementMount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide Continuing Medical Education for physicians.Mount Sinai School of Medicine designates this educational activity for a maximum of 3.0 Category 1 credit(s) toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the educational activity.It is the policy of Mount Sinai School of Medicine to ensure fair balance, independence, objectivity and scientific rigor in all its sponsored activities. All faculty participating in sponsored activities are expected to disclose to the audience any real or apparent discussion of unlabeled or investigational use of any commercial product or device not yet approved in the United States.This activity has been peer-reviewed and approved by Eric Hollander, MD, professor of psychiatry, Mount Sinai School of Medicine. Review Date: November 1, 2005. To Receive Credit for This ActivityRead this article, and...

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Section: Discussionmentioning

confidence: 99%

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

et al. 2005

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“…rTMS procedure. To target the same cortical location in all subjects, we used a procedure developed in our first TMS-PET study (for details, see Paus et al, 1997;Paus, 2002), which takes advantage of both standardized stereotaxic space and frameless stereotaxy. In short, MR images (160 continuous 1-mm thick saggital slices) of the subject's brain were acquired and the MDLFC coordinates in MNI space were transformed to the subject's brain coordinate (ie 'native') space.…”

Section: Experiments 1: the Effect Of 10-hz Rtms On Affect And Speechmentioning

confidence: 99%

Mechanisms of Action Underlying the Effect of Repetitive Transcranial Magnetic Stimulation on Mood: Behavioral and Brain Imaging Studies

Barrett

Della‐Maggiore

Chouinard

et al. 2004

Neuropsychopharmacol

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In a set of experiments, we applied 10-Hz repetitive transcranial magnetic stimulation (rTMS) over the left mid-dorsolateral frontal cortex (MDLFC) to investigate rTMS-induced changes in affective state and neural activity in healthy volunteers. In Experiment 1, we combined 10-Hz rTMS with a speech task to examine rTMS-induced changes in paralinguistic aspects of speech production, an affect-relevant behavior strongly linked to the ACC. In Experiment 2, we combined 10-Hz rTMS with positron emission tomography (PET) and used partial least squares (PLS) to identify a pattern of brain regions whose connectivity with the site of stimulation varied as a function of rTMS. The results of Experiment 1 revealed that following stimulation of the left MDLFC, subjects reported having less positive affect and vitality and displayed more monotonous speech. In Experiment 2, results revealed that 10-Hz rTMS influenced the covariation between blood flow at the site of stimulation (ie the left MDLFC) and blood flow in a number of affect-relevant brain regions including the perigenual anterior cingulate gyrus, insula, thalamus, parahippocampal gyrus, and caudate nucleus. Taken together, our results suggest that changes in affect and affect-relevant behaviour following 10-Hz rTMS applied over the left MDLFC may be related to changes in neural activity in brain regions widely implicated in affective states, including a frontocingulate circuit.

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“…Initial studies used fluorodeoxyglucose (George et al, 1995;Kimbrell et al, 1999) or oxygen (O15) (Paus et al, 1997;Paus and Wolforth, 1998) positron emission tomography (PET). Our group at the Medical University of South Carolina (MUSC) pioneered and developed a technique for interleaving TMS with blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) Shastri et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Interleaved Transcranial Magnetic Stimulation/Functional MRI Confirms that Lamotrigine Inhibits Cortical Excitability in Healthy Young Men

Tenebäck

Nahas

et al. 2004

Neuropsychopharmacol

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Little is known about how lamotrigine (LTG) works within brain circuits to achieve its clinical effects. We wished to determine whether the new technique of interleaved transcranial magnetic stimulation (TMS)/functional magnetic resonance imaging (fMRI) could be used to assess the effects of LTG on activated motor or prefrontal/limbic circuits. We carried out a randomized, double-blind, crossover trial involving two visits 1 week apart with TMS measures of cortical excitability and blood oxygen level-dependent TMS/fMRI. Subjects received either a single oral dose of 325 mg of LTG or placebo on each visit. In all, 10 subjects provided a complete data set that included interleaved TMS/fMRI measures and resting motor threshold (rMT) determinations under both placebo and LTG conditions. A further two subjects provided only rMT data under the two drug conditions. LTG caused a 14.979.6% (mean7SD) increase in rMT 3 h after the drug, compared with a 0.6710.9% increase 3 h after placebo (t ¼ 3.41, df ¼ 11, po0.01). fMRI scans showed that LTG diffusely inhibited cortical activation induced by TMS applied over the motor cortex. In contrast, when TMS was applied over the prefrontal cortex, LTG increased the TMS-induced activation of limbic regions, notably the orbitofrontal cortex and hippocampus. These results suggest that LTG, at clinically relevant serum concentrations, has a general inhibitory effect on cortical neuronal excitability, but may have a more complex effect on limbic circuits. Furthermore, the interleaved TMS/fMRI technique may be a useful tool for investigating regional brain effects of psychoactive compounds.

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Transcranial Magnetic Stimulation during Positron Emission Tomography: A New Method for Studying Connectivity of the Human Cerebral Cortex

Cited by 651 publications

References 44 publications

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

Mechanisms of Action Underlying the Effect of Repetitive Transcranial Magnetic Stimulation on Mood: Behavioral and Brain Imaging Studies

Interleaved Transcranial Magnetic Stimulation/Functional MRI Confirms that Lamotrigine Inhibits Cortical Excitability in Healthy Young Men

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